1979, 11-06 Permit: 79-7342 Residence Renewal of N1360PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
S. /5-45 13,F-7-114/1/4-14
LOT BLOCK SUBDISION
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
PAUL DANA
ADDRESS
PHONE
5'34 —1777
PARCEL NUMBER/S 2).1.533 –1004 L y-rs 1,273/i1
�sS µLoy BLACK II, BE--r-rhAN ADO7Tr J
S. 1574 Bx i I MAtJ
CONTRACTOR
a. SAM —
ADDRESS
SpaocAl1L
ZIP
iclzo 6
Required Set
North Ex
Backs in Feet
South
DESIGNER
5' ADDRESS
PHONE
ZIP
PHONE
Size of Parcel
/3s IX
Type Const. Occupancy
t/ -N
East (West 1
Zone lassification
Aro, icJ.lL-tU J L SL48
Sprinklered
❑Yes ❑No 0 Req'd.
Valuation
o
Building Area in Sq. Ft.
3220
ZIP
DWL Area
3 Z2.o
Basement Area Garage Area
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
L
Storage
Rancher
TYPE
7. OF
WORK
❑ NEW
❑ BLD.
❑ ALT.
❑ PLMB.
❑ AD'N. 0 RPL. 0 MVE.
O MECH: 0 M.H. 0 POOL
OTHER
No. Baths
No. Floors
3
No. Rooms
Rec. Room
Yrs
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
t�
DESCRIBE WORK
8. RENEW Ai_ 0 P
VALUATION
9. O
sti)s-Alr,- GAfAGE NOP- - D .ks AYr-rAcye-tP
Source GAS ELECTRIC WATER SEWER
of
Utilities Fry A Crp...`�
SE w-
I hereby certify that I have read and
on reverse side, and know the same
type of work will be complied with
to give authority to violate or cancel
performance of construction.
DATE 1 l - 77
examined this application and have read
to be true and correct. All provisions of
whether specified herein or not. The
the provisions of any other state or .cal
SIGNATUR
the "NOTICE" provisions included
laws and ordinances governing this
ting of a permit does not presume
aw regulating construction or the
SPECIAL APPROVALS
DEPT. REQ'D_
REC'D.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
RENEWAL OP PE .M rr 140.
N )3GO
R64 F. —'1• 3Lf
X.r u -Md_ FEE, _4°67
f'EoWT F'xff-S NOIIb 5,1180
DATE /1-6 OFFICIAL
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building f y
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
OO
TOTAL $ 67
PERMIT NUMBER
79 -732-/ _2,
DATE I/ to`71
02* *67.00
*67,00 6,5
*67,00
B *Q00
734.1 1
11-06-79
§ 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
11-06 `7'9
7'34.2Fl ,*67,00°1